{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T11:50:31Z","timestamp":1792324231799,"version":"4.4.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,3,19]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in American Indian people. In 2022, the American Heart Association developed the Life's Essential 8 goals to promote cardiovascular health (CVH) for Americans, composed of diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, blood pressure, and blood glucose. We examined whether achievement of Life's Essential 8 goals was associated with incident CVD among SHFS (Strong Heart Family Study) participants.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">A total of 2139 SHFS participants without CVD at baseline were included in analyses. We created a composite CVH score based on achievement of Life's Essential 8 goals, excluding sleep. Scores of 0 to 49 represented low CVH, 50 to 69 represented moderate CVH, and 70 to 100 represented high CVH. Incident CVD was defined as incident myocardial infarction, coronary heart disease, congestive heart failure, or stroke. Cox proportional hazard models were used to examine the relationship of CVH and incident CVD. The incidence rate of CVD at the 20\u2010year follow\u2010up was 7.43 per 1000 person\u2010years. Compared with participants with low CVH, participants with moderate and high CVH had a lower risk of incident CVD; the hazard ratios and 95% CIs for incident CVD for moderate and high CVH were 0.52 (95% CI, 0.40\u20130.68) and 0.25 (95% CI, 0.14\u20130.44), respectively, after adjustment for age, sex, education, and study site.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Better CVH was associated with lower CVD risk which highlights the need for comprehensive public health interventions targeting CVH promotion to reduce CVD risk in American Indian communities.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.032918","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T10:57:24Z","timestamp":1709895444000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Association of Achievement of the American Heart Association's Life's Essential 8 Goals With Incident Cardiovascular Diseases in the SHFS"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9136-2538","authenticated-orcid":false,"given":"Pyone Yadanar","family":"Paing","sequence":"first","affiliation":[{"name":"Department of Epidemiology University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4247-8286","authenticated-orcid":false,"given":"Alyson J.","family":"Littman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6640-6543","authenticated-orcid":false,"given":"Jessica A.","family":"Reese","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center Oklahoma City OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7656-7482","authenticated-orcid":false,"given":"Colleen M.","family":"Sitlani","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2746-3350","authenticated-orcid":false,"given":"Jason G.","family":"Umans","sequence":"additional","affiliation":[{"name":"MedStar Health Research Institute Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2651-0127","authenticated-orcid":false,"given":"Shelley A.","family":"Cole","sequence":"additional","affiliation":[{"name":"Texas Biomedical Research Institute San Antonio TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6945-3743","authenticated-orcid":false,"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center Oklahoma City OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9176-879X","authenticated-orcid":false,"given":"Tauqeer","family":"Ali","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center Oklahoma City OK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5358-2345","authenticated-orcid":false,"given":"Amanda M.","family":"Fretts","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Washington Seattle WA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","unstructured":"Center of Disease Control and Prevention . 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Education materials and resources (online catalog) | division of diabetes treatment and prevention (DDTP). Division of Diabetes Treatment and Prevention. Available at: https:\/\/www.ihs.gov\/diabetes\/education\u2010materials\u2010and\u2010resources\/. Accessed February 16, 2024.","journal-title":"Division of Diabetes Treatment and Prevention"},{"key":"e_1_3_2_36_2","unstructured":"Anon . Health promotion\/disease prevention | Indian Health Service (IHS). 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